Healthcare Provider Details

I. General information

NPI: 1679524680
Provider Name (Legal Business Name): HOLIDAY EQUIPMENT CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/14/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

396 RUE DE LA OR
SPARKS NV
89434-9521
US

IV. Provider business mailing address

396 RUE DE LA OR
SPARKS NV
89434-9521
US

V. Phone/Fax

Practice location:
  • Phone: 775-342-6169
  • Fax:
Mailing address:
  • Phone: 775-342-6169
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code335V00000X
TaxonomyPortable X-ray and/or Other Portable Diagnostic Imaging Supplier
License Number69528
License Number StateNV

VIII. Authorized Official

Name: MARY EUGENIA ANDERSON
Title or Position: DIRECTOR
Credential: RN
Phone: 775-342-6169